NPI | 1114217551 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207WX0200X Ophthalmology Ophthalmic Plastic and Reconstructive Surgery (Licence: FL ME109606) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME 109606) |
2082S0099X Plastic Surgery Plastic Surgery Within the Head and Neck (Licence: FL ME109606) | |
Enumeration Date | 2011-04-18 |
Last Update Date | 2022-07-21 |